Abstract：Objective：To observe the clinical efficacy of internal use of Wuwei Xiaodu Decoction combined with external application of Tianbo Jinhuang Powder in treating subacute thyroiditis （SAT） of heat toxin abundance type. Methods： A total of 86 SAT patients admitted to Foshan Hospital of Traditional Chinese Medicine from February 2022 to January 2024 were selected and randomly divided into the control group and the observation group using the random number table method，with 43 cases each. During the treatment period，six cases from the observation group and five from the control group dropped out，resulting in 75 patients completing the study （the control group：38 cases； the observation group： 37 cases）. The control group received oral Diclofenac Sodium Sustained-Release Tablets， while the observation group received additional internal use of Wuwei Xiaodu Decoction and external application of Tianbo Jinhuang Powder. Both groups were treated for two weeks. The symptom disappearance time， thyroid function indicators， thyroid antibody levels， inflammatory factors， oxidative stress factors， ultrasound-related indicators， pain scores，and incidence of adverse reactions were compared between the two groups. Results：The disappearance times for thyroid swelling， anterior neck pain， and body temperature normalization in the observation group were shorter than those in the control group （P＜0.05）. After treatment，serum levels of free triiodothyronine （FT3），free thyroxine（ FT4），thyroid peroxidase antibody（ TPOAb），thyroglobulin antibody（ TGAb），C-reactive protein（ CRP）， interleukin-6（ IL-6），erythrocyte sedimentation rate（ ESR），and malondialdehyde（ MDA） decreased in both groups， while thyroid-stimulating hormone （TSH） and superoxide dismutase （SOD） levels increased compared to pre-treatment levels （P＜0.05）. The observation group showed lower levels of FT3， TPOAb， TGAb， CRP， IL-6， ESR， and MDA，and higher levels of TSH and SOD than the control group （P＜0.05）. After treatment，peak thyroid artery flow velocity and elasticity modulus decreased in both groups （P＜0.05），with lower values in the observation group than in the control group（ P＜0.05）. Visual Analogue Scale（ VAS） of pain and Numerical Rating Scale（ NRS） scores decreased in both groups after treatment （P＜0.05）， with lower scores in the observation group than in the control group （P＜ 0.05）. No significant differences was found in the incidence of adverse reactions between the two groups （P＞0.05）. Conclusion：The combination of internal use of Wuwei Xiaodu Decoction and external application of Tianbo Jinhuang Powder effectively improves thyroid function， reduces serum thyroid antibody expression， ameliorates thyroid size， blood flow velocity，and hardness，and promotes recovery in SAT patients，potentially by inhibiting inflammatory and oxidative stress responses.